Market Rasen Surgery

Updated 6 June 2016

Market Rasen Surgery provides primary medical care for 10,165 patients living in the small market town of Market Rasen and the surrounding villages.

The town is located equidistantly between Lincoln, Grimsby and Louth where there are hospitals providing a range of acute, out-patient and associated healthcare services including out-of-hours GP services.

The surgery was purpose built in 1991 and was extended in 1996. All consultation, clinical and treatment rooms are on the ground floor as are the reception and dispensary. The building is well adapted and equipped to meet the needs of people with using wheelchairs.

The service is provided under a General Medical Services contract with Lincolnshire East Clinical Commissioning Group.

It is a dispensing practice, providing the service to approximately 60% of its patients.

Care and treatment is provided by four partners and one salaried GP (WTE 4.6), a nurse practitioner, five practice nurses, two phlebotomist , one bank phlebotomist and two healthcare assistant. They are supported by a team of dispensers, receptionists and administration staff.

The practice has fewer number of older people aged over 75 on the patient list than the national average. However there is a higher percentage of patients aged 40 to 60 years of age.

The reception is open between 8.30am and 6.30pm Monday to Friday. The practice was closed on the afternoon of the third Thursday of every month to allow for staff training.

When the surgery is closed GP out-of- hours services are provided by provided by Lincolnshire Community Health Services NHS Trust which can be contacted via NHS111.

Updated 6 June 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Market Rasen Surgery on 21 April 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 6 June 2016

The practice is rated as good for the care of people with long-term conditions.

• 65% of patients had a long standing health condition, compared to the national average of 54%.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• The management of people with long term conditions was good. For example The percentage of patients with diabetes, on the register, in whom the last blood pressure reading was 140/80 mmHg or less was 87% compared to the national average of 78%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 6 June 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.

• Rates were higher than the CCG average for all standard childhood immunisations.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The percentage of women aged 25-64 whose notes record that a cervical screening test has been performed in the preceding 5 years was 81%, the same as the national average.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives and health visitors.

Updated 6 June 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• The practice had appointed an experienced nurse to manage the healthcare needs of this population group.

Updated 6 June 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• Consultations with healthcare professionals were available at various times including

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice offered a full contraception service including coil fitting and vasectomies.

• Minor surgery including that involving conscious sedation was available within the surgery.

Updated 6 June 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 6 June 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability , vulnerable adults and the profoundly disabled.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice informed vulnerable patients and carers about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.